The Effect of Spironolactone on the Incidence of Contrast-Induced Nephropathy in Patients Undergoing Cardiac Catheterization: Study Design and Rationale

被引：5
作者：
Mujtaba A. [1 ]
Taher M.A. [1 ]
Hazza M.A. [2 ]
Al-Rubaye H.M. [3 ]
Kata A.H. [3 ]
AbdulWahab H. [3 ]
AbdulBari A.A. [2 ]
AlRubay H.K. [4 ]
机构：
[1] Department of Clinical Pharmacy, College of Pharmacy, University of Baghdad, Basra
[2] College of Medicine, University of Basra, Basra
[3] Basra Cardiac Catheterization Center, Basra
[4] AlSader Teaching Hospital, Basra
来源：
Cardiology and Therapy | 2018年 / 7卷 / 1期
关键词：
Acute kidney injury (AKI); Aldactone; Angiography; Angioplasty; Contrast-induced nephropathy (CIN); Ischemic heart disease (IHD); Percutaneous coronary angiography (PCI); Spironolactone;
D O I：
10.1007/s40119-018-0112-3
中图分类号：
学科分类号：
摘要：
Introduction: Patients undergoing coronary catheterization are at high risk of developing contrast-induced nephropathy (CIN) acute kidney injury (AKI). Several approaches have been supposed to limit such an effect but with mixed results or non-practical methods. Spironolactone is supposed to be effective as a nephroprotective agent in animal studies. This study will try to measure the effect of spironolactone on the incidence of CIN-AKI in patients undergoing coronary catheterization (angiography angioplasty). Methods: This study is a single-center, investigator-driven, double-blinded randomized controlled study in Iraq-Basra. More than 400 patients admitted for coronary angio unit in our center will be allocated in a 1:1 ratio to receive either spironolactone 200 mg single dose or placebo in addition to their usual premedication. Planned Outcomes: Primary end point will be CIN defined as more than 25% or 0.3 mg/dl elevation in serum creatinine (S.Cr.) from baseline during the first 2–3 days after the procedure. We hope to identify or answer an important question regarding CIN in such high-risk patients. Trial Registration: ClinicalTrials.gov Identifier, NCT03329443. © 2018, The Author(s).
引用
收藏
页码：101 / 106
页数：5
相关论文
共 24 条
  • [1] Tehrani S., Et al., Contrast-induced acute kidney injury following PCI, Eur J Clin Invest, 43, pp. 483-490, (2013)
  • [2] Tziakas D., Et al., Validation of a new risk score to predict contrast-induced nephropathy after percutaneous coronary intervention, Am J Cardiol, 113, pp. 1487-1493, (2014)
  • [3] Sadeghi H.M., Stone G.W., Grines C.L., Et al., Impact of renal insufficiency in patients undergoing primary angioplasty for acute myocardial infarction, Circulation, 108, pp. 2769-2775, (2003)
  • [4] Liu M., Et al., Aggressive hydraTion in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention to prevent contrast-induced nephropathy (ATTEMPT): study design and protocol for the randomized, controlled trial, the ATTEMPT, RESCIND 1 (First study for REduction of contraSt-induCed nephropathy following carDiac catheterization) trial, Am Heart J, 172, pp. 88-95, (2016)
  • [5] Droppa M., Desch S., Blase P., Et al., Impact of N-acetylcysteine on contrast-induced nephropathy defined by cystatin C in patients with ST-elevation myocardial infarction undergoing primary angioplasty, Clin Res Cardiol, 100, pp. 1037-1043, (2011)
  • [6] Thayssen P., Lassen J.F., Jensen S.E., Et al., Prevention of contrast-induced nephropathy with N-acetylcysteine or sodium bicarbonate in patients with ST-segment-myocardial infarction: a prospective, randomized, open-labeled trial, Circ Cardiovasc Interv, 7, pp. 216-224, (2014)
  • [7] Navarro R.B., Et al., The effect of spironolactone on acute kidney injury after cardiac surgery: a randomized, placebo-controlled trial, Am J Kidney Dis, (2016)
  • [8] Mejia-Vilet J.M., Et al., Renal ischemia-reperfusion injury is prevented by the mineralocorticoid receptor blocker spironolactone, Am J Physiol Renal Physiol, 293, pp. F78-F86, (2007)
  • [9] Sanchez-Pozos K., Et al., Recovery from ischemic acute kidney injury by spironolactone administration, Nephrol Dial Transplant, 27, pp. 3160-3169, (2012)
  • [10] Pretorius M., Et al., Angiotensin-converting enzyme inhibition or mineralocorticoid receptor blockade do not affect prevalence of atrial fibrillation in patients undergoing cardiac surgery, Crit Care Med, 40, 10, pp. 2805-2812, (2012)
123